Health Brief: Senate Leaves for Recess Without Obamacare Game Plan

Government Brief

Senate Republicans left Washington for the August recess without a clear path forward on health care. GOP leaders want to move onto other issues, while conservatives hope to revive the push to repeal the Affordable Care Act and centrists aim to bolster the law’s exchanges for next year. (Politico)

Bipartisan efforts to stabilize the ACA markets could run into conflict over clashing views on deregulating health plans, specifically about how to drive down premiums for the young and healthy without driving up costs for people with pre-existing conditions. (Modern Healthcare)

Fifteen states that haven’t expanded Medicaid have gubernatorial races in 2018. Even if Democrats are only able to win a few of the contests, it gives them a chance to cover millions of currently uninsured people. (Axios)

Business Brief

Big insurers are reducing their participation in the ACA in areas where fighting over the future of the law is contributing to financial losses. Instead, they are looking for business opportunities through Medicare Advantage, a politically popular program that’s being embraced by a growing number of seniors. (Bloomberg)

The nation’s largest retail pharmacies are taking a more hardline negotiating approach when buying generic drugs, accelerating a decline in prices that is likely to affect pharmaceutical companies for some time, according to industry experts. (Reuters)

The Trump administration has continued an Obama administration policy to penalize hospitals for having too many patients return within a month. (Kaiser Health News)

General

Republicans are leaving Washington Thursday for a month of recess with no clear direction on what they’ll do next on Obamacare. Senate leaders want to just drop the issue altogether. Conservatives say they’re still fighting for repeal. Moderates want to launch a bipartisan effort to fix the shaky Obamacare system.

Fledgling efforts in the Senate and U.S. House of Representatives to develop bipartisan legislation to stabilize the individual insurance market could founder over clashing views on deregulating health plans. Democrats and a growing number of Republicans are eager to steady the struggling individual market covering nearly 20 million Americans to prevent an exodus of insurers and healthy customers.

In 2009 a Democratic Congress and president gave the U.S. Food and Drug Administration the power to regulate tobacco. Eight years later, under a White House and Congress controlled by Republicans, the FDA made its strongest use of that authority.

Senate Finance Committee Chairman Orrin Hatch (R-Utah) announced Thursday that the panel will hold a healthcare hearing in September, in the wake of a failed vote on repeal of ObamaCare. The hearing will be a chance for members of both parties to discuss the healthcare law, and it comes amid calls for a return to regular order and the committee process.

Creating “designer babies” with a revolutionary new genome-editing technique would be extremely difficult, according to the first U.S. experiment that tried to replace a disease-causing gene in a viable human embryo. Partial results of the study had leaked out last week, ahead of its publication in Nature on Wednesday, stirring critics’ fears that genes for desired traits — from HIV resistance to strong muscles — might soon be easily slipped into embryos. In fact, the researchers found the opposite: They were unable to insert a lab-made gene.

European and Asian stocks drifted and bonds were mixed as investors pondered the latest drama in Washington while they wait for new clues on the U.S. economy. The euro hit a fresh two-and-a-half year high against the dollar and oil retreated.

Thousands of low-income patients may have to scramble to find new doctors this month after University of Chicago Medicine became the latest major health system to break up with IlliniCare Health, an insurer that administers benefits for the state’s Medicaid program. U. of C. Medicine follows Northwestern Medicine and Advocate Health Care in walking away from IlliniCare Health, one of 12 Medicaid managed care organizations in the state.

Kaiser Permanente will be tested to repeat the record $1 billion in operating income it posted in the first quarter. After all, the Oakland, Calif.-based hospital and managed-care giant is swimming against the same national trends that dented the earnings of investor-owned hospital chains in the second quarter.

Providers

Amid all the turbulence over the future of the Affordable Care Act, one facet continues unchanged: President Donald Trump’s administration is penalizing more than half the nation’s hospitals for having too many patients return within a month. Medicare is punishing 2,573 hospitals, just two dozen short of what it did last year under former President Barack Obama, according to federal records released Wednesday.

Medicare’s final 2018 hospital payment rule set in stone a spate of policies — ranging from a withdrawn proposal that would have required accrediting bodies to make confidential hospital inspections public to a new (and unpopular) system for calculating hospitals’ uncompensated care. But a handful of other payment policy changes also will go into effect next year, pleasing the various companies and industries that lobbied the Centers for Medicare and Medicaid Services.

Pharma, Biotech and Devices

The largest U.S. retail pharmacies, including Wal-Mart Stores Inc and Walgreens Boots Alliance Inc, are wielding more leverage when buying generic drugs, accelerating a decline in prices likely to affect drug companies for some time, industry experts said on Thursday. That pressure is exacerbated by efforts from U.S. health regulators to speed approval of copycat drugs, industry sources said.

The Senate on Thursday gave final approval to legislation to finance the Food and Drug Administration, clearing the measure for President Trump and tapping drug manufacturers once again to help pay for the federal review of prescription drugs and medical devices. The 94-to-1 vote came just hours after the Senate passed a separate bill expanding access to experimental treatments for people with terminal illnesses.

Regeneron Pharmaceuticals Inc reported a much better-than-expected quarterly profit on strong demand for its flagship Eylea drug and said it would end one of its agreements with France’s Sanofi SA to develop antibodies by the end of the year. Shares of Regeneron, which also raised its full-year growth forecast for the eye treatment, closed down 2 percent at $467.11 on Thursday.

Health IT

Hailed as the future of preventive care, wearable health devices allow doctors to keep closer tabs on the health of patients as they go about their daily routines. But as health systems consider these medical-grade devices, hoping to lower costs associated with hospital readmissions, they have also raised concerns about potential security risks to patients and to the hospitals connected with them.

A Message from PhRMA:

Myth: U.S. government would make sure medicines are safe. Fact: The government has authority to allow drug importation if the secretary of HHS certifies imports would not threaten the health and safety of Americans and would generate cost savings for consumers. No secretary has been able to do that. Allowing the importation of drugs from other countries into the U.S. would lead to potentially dangerous outcomes for patients and increase the burden on law enforcement to prevent unregulated medicines from harming Americans. Get the facts at http://onphr.ma/2u12plT

Opinions, Editorials and Perspectives

Republican plans to repeal the Affordable Care Act were like something out of a B horror movie: terrifying at times, very unrealistic and surprisingly difficult to kill. Fortunately for America’s small businesses, conservative lawmakers failed for now to gut the ACA.

If either of us were building the American health care system from scratch, we’d probably end up in different places. We have contrasting ideas — one of us is a Democrat, the other a Republican — about what ails the system and how to reshape it.

Research Reports

If nothing is done, we can expect a lot of people to die: A forecast by STAT concluded that as many as 650,000 people will die over the next 10 years from opioid overdoses — more than the entire city of Baltimore. The US risks losing the equivalent of a whole American city in just one decade.